[1]A few weeks ago I published an article entitled “Responsibility, Solidarity, and Healthcare [2],” its several points being:
- Covering routine, non-catastrophic healthcare increases costs and reduces access to healthcare in two ways
a. it makes the health care cost more
b. it makes insurance more costly - The Catholic principle of solidarity means that we should not only seek what will provide the most access to healthcare for the most people, but also that each person should take proper responsibility for his or her own health, including some burden of the cost of that care.
This article provoked a very welcome discussion on Linkedin among some members of the Atlanta Catholic business conference. (You do not have to live in Atlanta to join this Linkedin group managed by Randy Hain, so please join for great encouragement in living our faith in the workplace.) I am going to reprise a bit of the back and forth here, because I think the bottom line in this discussion has risen dramatically to the fore nationally now that publicly backed government-mandated birth control coverage has been recommended by the Institute of Medicine to the salivating delight of money-grubbing anti-natalists at Planned Parenthood.
In response to my article one person posted:
I think the Church teaches that we have a duty to insure health care to all. Of course, we must try to prevent fraud and waste and we live in a time of limited resources, but I would rather waste some money than have people suffer and in some cases die from a lack of adequate health care. This is solidarity. This is in line with St. Thomas Aquinas’s idea of the universal destination of all goods.
This seems to be in line with the thinking of our pope.
This writer went on to reference the pope’s remarks to the 25th International Conference of the Pontifical Council for Health Care Ministry at the Vatican Nov 18, 2010. The pope’s full address is here: http://www.zenit.org/article-31001?l=english [3]. Particularly pertinent to this discussion are these parts of it:
The topic chosen by you this year “Caritas in Veritate — For Equitable and Human Health Care,” is of particular interest for the Christian community, in which the care of the human being is central, because of his transcendent dignity and inalienable rights. Health is a precious good for the person and society to promote, conserve and protect, dedicating the means, resources and energies necessary so that more persons can enjoy it. Unfortunately, the problem still remains today of many populations of the world that do not have access to the necessary resources to satisfy fundamental needs, particularly in regard to health. It is necessary to work with greater commitment at all levels so that the right to health is rendered effective, favoring access to primary health care.
…
Important also in the field of health, integral part of each one’s existence and of the common good, is to establish a true distributive justice that guarantees to all, on the basis of objective needs, adequate care….
…
Health justice should be among the priorities of governments and international institutions….
…
“I hope for […] the adoption of a model of development founded on the centrality of the human being, on the promotion and sharing of the common good, on responsibility, on the awareness of the necessary change of lifestyles and on prudence, virtue that indicates the actions to be carried out today, in expectation of what might happen tomorrow” (Benedict XVI, Message for the 2010 World Day of Peace, 9).
I will be coming back to the pope’s remarks shortly but for the moment back to the discussion, where the aforementioned respondent opined:
Perhaps universal health coverage pushes the limits of normal insurance principles on covering risks. But the greater question then becomes how do we make sure that our insurance or other means of coverage covers all reasonable risks. So whether it is insurance, governmental assistance or some combination, we must seek to cover all people and their reasonable health needs and I would include as reasonable an expanded coverage beyond catastrophic needs.
How we do this and prevent abuse is a fair question. As with any benefit, we should not abuse the benefit. But let us not fail to cover the real health care needs of others in the hunt to reduce fraud and waste.
A second person responded:
More directly to Mary [Kochan’s] main point: “universal health insurance” is mainly a universal payment system, and a poor one at that. Mary is absolutely right that it has caused many people to believe that someone else will pay for “routine”, known services. When “someone else pays”, of course one becomes less discerning.
One more point, about the teaching of the Church: yes, we are all compelled to help serve the needs of the poor and generally our fellow man. But that duty is a personal duty — it does not necessarily translate into a mandate requiring us to act through the Government!
Then a third chimed in with this helpful effort at defining terms and locating the crux of the issue:
It does seem like this dialogue is dealing with the common “misinformation” about terms that politicians like to use to muddy the water. Speaking from a layman’s perspective:
Health Care (vs less clear Health coverage) has to do with preventative, corrective, or palliative care to either maintain health, restore health, or minimize the suffering condition.
Health Cost/Payment: The who, how much, and what of incurring and paying for health care.
Health Insurance: A solution for minimizing the risk to some population that any one person will face the inability to get care for a catastrophic illness or event.
Health coverage: Seems to be a blending of the three terms above such that it is interpreted as the collective approach to how someone will receive health care, pay for health care, and share the burden of risk management.
I think most people would agree that an approach to maximize the opportunity for each person to be able to receive essential health care is a desired goal. The questions, I believe, that separate opinions has to do with questions like the following which then dictates the kind of approach one agrees with using:
1. Who/what gets to determine each person’s essential health care? Secondary question, does that criteria vary by demographics (age, education level, income level…)?
2. Does government have the right to mandate that care and/or how it will be funded?
3. If the answer to question 2 is yes, then what principles, morals, ethics, etc dictate how the government decides to mandate that? Secondary question, what other civil liberties (like religious freedom) would supersede that formation upon which those mandates are derived?
All of these questions come into play when we begin to a) define health care as a right that government must defend/enforce and b) determine the payment/insurance approach to that right is, by extension, included in the government’s obligation to defend/enforce that right.
Oh what a Pandora’s box we have opened.[Minor edits and emphasis mine.]
The issue of freedom having been well-broached now, the first respondent rejoined:
Well, as I read Catholic social doctrine and an ideal of solidarity, we have a social obligation to secure health care for all and governments need to devote the necessary resources. Once again I cite the pope… [who noted] that because an individual’s health is a ‘precious asset’ to society as well as to himself, governments and other agencies should seek to protect it by ‘dedicating the equipment, resources and energy so that the greatest number of people can have access.’ He declared the adequate access to healthcare ‘an inalienable right.’ He does not seem to privilege individual liberty over a communal responsibility in this context. Quite the contrary.
Of course, he is not suggesting that we eliminate our liberty but that we use it humanely and collectively on behalf of those in need through our social institutions including our governments. Am I wrong in my interpretation of his view?…
[…] How we get from a general duty for health care to specific, effective policies is a political and perhaps economic minefield. But I would contend that we cannot and should not rest while we have brothers and sisters without health care or without adequate healthcare. This is the REAL problem. We can debate what defines an adequate level of care and who makes the decisions. Fair enough. Should it be mandatory? If the government offered health insurance or coverage but did not require it, would this meet some of your liberty concerns?
My concern here is whether we agree to not rest until we get healthcare to those in need. We must keep going despite the obstacles. Inaction is worse than a less than perfect plan. The good is not the enemy of the perfect. We can always modify an imperfect plan. You may disagree. But, for me, the current situation is scandalous and I pray that we have the collective wisdom to resolve this issue in a form consistent with the obligations of our faith and our reason. This is no small task. [Minor edits mine.]
I am very grateful to these and others who so thoughtfully engaged my article on Catholic Lane, Linkedin and Facebook. This topic is currently one of the most important in our national civic life and is of vital personal importance to us all. I want to start my own thoughts with an engagement of the comments of our Holy Father. I want to focus on the issue of rights momentarily because the pope is very clear that an appreciation of the transcendent dignity of the human person requires the acknowledgement that human beings are the bearers of inalienable rights. The pope did not say that health care itself is one of those inalienable rights, although he did talk about the right to healthcare. I am not saying that the pope does not consider healthcare an inalienable right, merely that he did not make that explicit statement.
My own reading of his comments would place the human dignity/rights language as a foundation for all discussion. We start with the understanding of human dignity, having as its basis the fact that man is made in God’s image. Proceeding from this is the understanding that God gives to human beings certain rights that government is obligated to respect and protect. This thinking is familiar to Americans as foundational to our system of government.
As Catholic Americans, we have to include in our thinking the mission that the Church is given by Christ, and the responsibilities that devolve upon each of us to assist that mission of carrying out through time and in our world the works that Jesus did. “Truly, truly, I say to you, he who believes in me will also do the works that I do; and greater works than these will he do, because I go to the Father” (John 14:12). That so much of Jesus’ earthly ministry was devoted to healing has always been seen as making healing a major part of the mission of the Church. A very Catholic expression then was uttered by my correspondent who said: “Let us not fail to cover the real health care needs of others in the hunt to reduce fraud and waste…. I would contend that we cannot and should not rest while we have brothers and sisters without health care or without adequate healthcare. … My concern here is whether we agree to not rest until we get healthcare to those in need. We must keep going despite the obstacles. … [F]or me, the current situation is scandalous.”
I agree, and it has now been made more, not less, scandalous by an administration that seems determined to break with previous administrations in respecting the conscience rights of healthcare providers and all citizens by forcing us all to be complicit in crimes against life. I think the current situation requires us to conceive of a hierarchy of rights and use that conception to craft our responses to the healthcare issue. I would like to propose that the right to religious freedom and its concomitant freedom of conscience absolutely has to be privileged above all other rights and obligations — in fact, the exercise of all other rights and the carrying out of all other obligations rests on this right as upon no other, save the right to life.
Obligations of charity do not trump religious freedom. The Church in the United States has demonstrated this by closing charitable missions, such as adoption agencies and medical facilities, when the state attempted to insist that Catholic facilities perform procedures that violate God’s law or place children with same-sex “couples”.
I believe the position of the Church in a country like ours, to the extent it can be said to have a “political position,” should always be to the maximizing of religious freedom and we Catholic citzens “with a firm reliance on the protection of Divine Providence,” ought “to mutually pledge to each other our Lives, our Fortunes, and our sacred Honor” in its defense. With maximum religious freedom, the Church and the Catholic people can accomplish making their case fairly in the public square for those policies that advance the common good and can themselves carry out the mission of Christ without impediment by running their own institutions with a minimum of government interference and with no government impingement upon freedom of religion or conscience.
I observe sadly that for some time the “right to health care” has trumped religious freedom as a Catholic concern in certain quarters. This has resulted in a health care agenda drifting ever further from accountability to the standard of human dignity, the crippling of Catholic institutions’ ability to respond to healthcare needs, and the gradual – but steadily increasing — muzzling of Catholic’s freedom in the public square.
The issue of freedom in healthcare goes way beyond the question of the constitutionality or lack thereof of some proposal to mandate health coverage purchases. The question of what limits may be placed on the power of this government has become crucial. It has become more crucial than the issue of healthcare and if that issue is not resolved on the freedom side of the ledger healthcare will be just one of the causalities.
(© 2011 Mary Kochan)